The Colonial Coin Collectors Club

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C4 Renewal Period

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C4 Application Form
(required for New members only)

(for convenience, print out a hard copy to submit with your payment)





I hereby apply for membership in the Colonial Coin Collectors Club.

Enclosed is $_____ in payment for dues.

Membership type:

____Regular $30.00 ($31.00/PayPal)

____Regular outside of USA $40.00 ($41.00/PayPal)

____Junior (under 18 years of age) $10.00 ($11.00/PayPal)

____Junior outside of USA $15.00 ($16.00/PayPal)

Collecting interests:____________________________________________


How did you learn about C4?______________________________________


Send check made payable to Colonial Coin Collectors Club or C4 to:

Charlie Rohrer (
C4 Treasurer
PO Box 25
Mountville, PA 17554

Or use PayNow (PayPal) button on this page to pay instantly. To use PayPal you must already have a PayPal account.

Life Membership is an option for members who have been in good standing in the club for at least two (2) years duration and are accepted by a two-thirds (2/3) vote of the Board of Directors.
Life Membership is twenty-five (25) times the cost of annual membership ... currently $750.00.


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